Reporting and improving on physician prescribing rates for end-of-life symptom control in long-term Care
The COVID-19 Pandemic Response and Impact Grant (Co-RIG) Program: Phase II focuses on innovations and initiatives that prepare family physicians and their interprofessional teams to cope with challenges related to the pandemic and its long-term impact.
This week we highlight Dr. Peter Tanuseputro and his team’s continued work on the project they started in Phase I of the Co-RIG program. With support from the Ottawa Hospital Research Institute their project used data collected across all long-term care (LTC) homes in Ontario (held at ICES). This data identified homes with low prescribing rates of palliative care medications for dying residents, a clear marker of palliative care delivery. Phase II of this endeavour focuses on the request from the Ontario Palliative Care Network (OPCN) to identify homes with low prescribing rates during the COVID-19.
The scope of this project has expanded to include:
- Identify and focus on prescriber characteristics that are associated with both low and high rates of prescribing.
- Build and report on an indicator for end-of-life prescribing rates for physicians working in LTC homes.
Residents of LTC homes – both those dying with and without COVID-19 infection – have end-of-life symptom needs that can partially be met through administration of palliative care medications, a good proxy to the delivery of palliative care which is not otherwise easily captured in physician billing data.
This project will lead to the development of a prescriber level indicator that can be fed back to individual physicians through the OPCN and the Ministry of Long-term Care. It will ultimately lead to practice feedback that is the first step in improving the quality of end-of-life care provided to LTC residents during and after the COVID-19 pandemic.
“If you have a patient in front of you and they have six months to live, or one year to live, should the discussion be continuing to try to cure, cure, cure…? Or should the conversation be let’s try to make your life the most comfortable and meaningful it can be?”